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Short report
Primary diffuse leptomeningeal gliomatosis simulating tuberculous meningitis
  1. J H Reesa,
  2. N Balakasc,
  3. A Agathonikoud,
  4. S F Haine,
  5. G Giovanonnia,
  6. C P Panayiotopoulosd,
  7. M Luxsuwongb,
  8. T Reveszb
  1. aUniversity Department of Clinical Neurology, Institute of Neurology, Queen Square, London WC1N 3BG, UK, bDepartment of Neuropathology, cDepartment of Neurology, Evangelismos Hospital, Athens, Greece, dDepartment of Clinical Neurophysiology and Epilepsies, St Thomas' Hospital, London, UK, eThe Clinical PET Centre
  1. Dr Jeremy Reesj.rees{at}ion.ucl.ac.uk

Abstract

Three patients are reported on who presented with communicating hydrocephalus due to presumed tuberculous meningitis. Subsequent clinical deterioration despite antituberculous chemotherapy prompted reassessment with FDG-PET scanning and meningeal biopsy in one case and repeat CSF cytology with special staining in the second. The third patient died and postmortem confirmed a diagnosis of primary diffuse leptomeningeal gliomatosis. In the first two patients, MRI of the entire neuraxis showed no evidence of a primary intraparenchymal tumour. These cases emphasise the need for repeated reassessment in patients with culture negative lymphocytic meningitis. In addition, this is the first report of FDG-PET scanning in leptomeningeal gliomatosis.

  • leptomeningeal
  • gliomatosis
  • tuberculous meningitis

https://doi.org/10.1136/jnnp.70.1.120

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